About 1,461 cardiovascular deaths in rural Australia could be delayed or averted each year with improvements in modifiable risk factors.

While they only account for 38% of the increased mortality burden in rural areas, the risk factors were ‘modest and achievable targets’ for health policy.

According to a Deakin University modeling study, obesity and smoking account for the largest number of cardiovascular and ischaemic heart disease (IHD) deaths that could be prevented if rural risk factors were more in line with those in metropolitan areas.

The study found people in rural Australia had a higher energy intake and higher fat diet than their city counterparts, although in their favour they ate 10% more vegetables and had a higher fibre intake.

Alcohol consumption was higher in women from the bush than those from the city but there was no similar difference in men overall and alcohol intake was lower in rural men older than 75 years.

Fewer rural people than city folk were meeting recommendations for physical activity.

The researchers said the differences in modifiable risk factors between rural and metropolitan areas were likely to be driven by socioeconomic disadvantage, education and health literacy levels, and access to primary health care. Energy intake was also likely to be influenced by reduced access to healthier foods.

“This analysis showed that more than one-third of the IHD mortality inequality between metro and rural areas can be attributed to differences in individual risk factors, an important consideration for health policy and intervention planning.”

“Differences in EI [energy intake] and physical activity energy expenditure between rural and metropolitan populations led to substantial reductions in obesity- mediated mortality in the counterfactual scenario,” the researchers said.

“Improving risk factor profiles in rural populations to at least match that of their metropolitan counterparts could be assumed to be a reasonable target, and is certainly a relatively modest goal, given that even metropolitan risk factor levels are far from ideal.”